scholarly journals Venetoclax (Venclexta)

2021 ◽  
Vol 1 (8) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Quality Of Life ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Free Survival ◽  
Transfusion Independence ◽  
Low Dose Cytarabine ◽  
Quality Adjusted Life ◽  
Public Drug ◽  
List Prices

CADTH recommends that Venclexta in combination with low-dose cytarabine (LDAC) should not be reimbursed by public drug plans for the treatment of patients with newly diagnosed acute myeloid leukemia (AML) who are 75 years or older, or who have comorbidities that preclude the use of intensive induction chemotherapy. Evidence from 1 clinical trial demonstrated that treatment with Venclexta plus LDAC did not improve overall survival compared to treatment with LDAC alone. No conclusions could be drawn for other important outcomes including remission rates, transfusion independence, event-free survival, quality of life, and symptoms. Patients identified a need for treatments that can maintain remission, improve quality of life and symptoms (fatigue), and that have fewer side effects. It is unclear whether Venclexta plus LDAC meets these needs. Economic evidence suggests that Venclexta plus LDAC is not cost-effective at a willingness-to-pay threshold of $50,000 per quality-adjusted life-year (QALY), even at a 100% reduction in the price of Venclexta. Based on public list prices, the 3-year budget impact is $70,006,541. This estimate is larger than the value identified by drug plans as feasible for adoption.

Quality of Life and Resource Allocation

1988 ◽  
Vol 23 ◽  
pp. 33-55 ◽  
Author(s):  
Michael Lockwood
Keyword(s):  
Quality Of Life ◽  
Resource Allocation ◽  
Quality Adjusted Life Year ◽  
Medical Resources ◽  
Medical Vocabulary ◽  
Quality Adjusted Life

A new word has recently entered the British medical vocabulary. What it stands for is neither a disease nor a cure. At least, it is not a cure for a disease in the medical sense. But it could, perhaps, be thought of as an intended cure for a medicosociological disease: namely that of haphazard or otherwise ethically inappropriate allocation of scarce medical resources. What I have in mind is the term ‘QALY’, which is an acronym standing for quality adjusted life year. Just what this means and what it is intended to do I shall explain in due course. Let me first, however, set the scene.

scholarly journals Cost-Effectiveness of Continuous Positive Airway Pressure Therapy in Patients with Obstructive Sleep Apnea-Hypopnea in British Columbia

2008 ◽  
Vol 15 (3) ◽  
pp. 159-165 ◽  
Author(s):  
MCY Tan ◽  
NT Ayas ◽  
A Mulgrew ◽  
L Cortes ◽  
JM FitzGerald ◽  
...  
Keyword(s):  
Quality Of Life ◽  
British Columbia ◽  
Cost Effectiveness ◽  
Quality Adjusted Life Year ◽  
Third Party ◽  
Cpap Therapy ◽  
Obstructive Sleep ◽  
The Cost ◽  
Quality Adjusted Life

BACKGROUND: Obstructive sleep apnea-hypopnea (OSAH) is a common disorder characterized by recurrent collapse of the upper airway during sleep. Patients experience a reduced quality of life and an increased risk of motor vehicle crashes (MVCs). Continuous positive airway pressure (CPAP), which is the first-line therapy for OSAH, improves sleepiness, vigilance and quality of life.OBJECTIVE: To assess the cost-effectiveness of CPAP therapy versus no treatment for OSAH patients who are drivers.METHODS: A Markov decision analytical model with a five-year time horizon was used. The study population consisted of male and female patients, between 30 and 59 years of age, who were newly diagnosed with moderate to severe OSAH. The model evaluated the cost-effectiveness of CPAP therapy in reducing rates of MVCs and improving quality of life. Utility values were obtained from previously published studies. Rates of MVCs under the CPAP and no CPAP scenarios were calculated from Insurance Corporation of British Columbia data and a systematic review of published studies. MVCs, equipment and physician costs were obtained from the British Columbia Medical Association, published cost-of-illness studies and the price lists of established vendors of CPAP equipment in British Columbia. Findings were examined from the perspectives of a third-party payer and society.RESULTS: From the third-party payer perspective, CPAP therapy was more effective but more costly than no CPAP (incremental cost-effectiveness ratio [ICER] of $3,626 per quality-adjusted life year). From the societal perspective, the ICER was similar ($2,979 per quality-adjusted life year). The ICER was most dependent on preference elicitation method used to obtain utility values, varying almost sixfold under alternative assumptions from the base-case analysis.CONCLUSION: After considering costs and impact on quality of life, as well as the risk of MVCs in individuals with OSAH, CPAP therapy for OSAH patients is a highly efficient use of health care resources. Provincial governments who do not provide funding for CPAP therapy should reconsider.

scholarly journals A systematic review of economic evaluations of the use of memantine alone or combined with donepezil for moderate to severe Alzheimer’s disease

2019 ◽  
Vol 22 (4) ◽  
Author(s):  
Ione Ayala Gualandi de Oliveira ◽  
Rosângela Caetano ◽  
Ricardo Ewback Steffen ◽  
Aline Navega Biz
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Markov Models ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Decision Models ◽  
Economic Evaluations ◽  
Eligibility Criteria ◽  
Quality Adjusted Life

Abstract Objective: To synthesize the available evidence and state of the art of economic evaluations which evaluate the use of memantine, whether alone or combined with donepezil, for moderate to severe Alzheimer’s disease (AD), focusing on the analytical decision models built. Method: The electronic databases MEDLINE, EMBASE, NHS EED, CEA Registry and LILACS were searched for references. After duplicates were removed, two independent reviewers evaluated the titles and abstracts and subsequently the full texts. The Drummond M. tool was used to evaluate the quality of the studies. Results: After the application of the eligibility criteria, twelve complete economic evaluations were included. One evaluation was a clinical trial, two involved simulations and nine used Markov models. The main outcome measure adopted was dominated by cost per quality adjusted life year (QALY). The use of memantine was considered cost-effective and dominant in eight studies; while in a single study, its use was dominated when compared to donepezil for moderate AD. Sensitivity analyzes were systematically performed, with robust results. The quality assessment indicated that the methodological quality of the studies was good. Conclusion: Although there is some controversy regarding the benefits derived from the use of memantine, whether combined or not with donepezil, the evidence collected suggests that it is cost-effective in the countries where the studies were performed. However, local economic studies need to be performed, given the significant variability derived from the different parameters adopted in the evaluations.

Comparison of Hemodialysis and Peritoneal Dialysis — a Cost–Utility Analysis

2002 ◽  
Vol 22 (1) ◽  
pp. 39-47 ◽  
Author(s):  
Karin Sennfält ◽  
Martin Magnusson ◽  
Per Carlsson
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Peritoneal Dialysis ◽  
Kidney Failure ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Age Group ◽  
The Cost ◽  
Quality Adjusted Life

Objective Our aim was to compare both health-related quality of life and costs for hemodialysis (HD) and peritoneal dialysis (PD) in a defined population. Design Decision-tree modeling to estimate total costs and effects for two treatment strategies, HD and PD, among patients with chronic kidney failure, for 5 years following the start of treatment. Courses of events and health-care consumption were mapped in a retrospective matched-record study. Data on health status were obtained from a matched population by a quality-of-life questionnaire (EuroQol). The study has a societal perspective. Setting All dialysis departments in the southeastern health-care region of Sweden. Patients 136 patients with kidney failure, comprising 68 matched pairs, were included in a retrospective record study; 81 patients with kidney failure, comprising 27 matched triplets, were included in a prospective questionnaire study. Main Outcome Measures Cost per life year and cost per quality-adjusted life year. Results The cost per quality-adjusted life year for PD was lower in all analyzed age groups. There was a 12% difference in the age group 21 – 40 years, a 31% difference in the age group 41 – 60 years, and an 11% difference in the age group 61+ years. Peritoneal dialysis and HD resulted in similar frequencies of transplantation (50% and 41%, respectively) and expected survival (3.58 years and 3.56 years, respectively) during the first 5 years after the initiation of treatment. Conclusion The cost–utility ratio is most favorable for PD as the primary method of treatment for patients eligible for both PD and HD.

Economic Evaluation of A Support Program for Caregivers of Demented Elderly

1991 ◽  
Vol 7 (2) ◽  
pp. 209-219 ◽  
Author(s):  
Michael F. Drummond ◽  
E. Ann Mohide ◽  
Michelle Tew ◽  
David L. Streiner ◽  
Dorothy M. Pringle ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Economic Evaluation ◽  
Statistical Significance ◽  
Quality Adjusted Life Year ◽  
Support Program ◽  
Caregiver Support ◽  
Health Care Interventions ◽  
Caregiver Quality ◽  
Quality Adjusted Life

AbstractAn economic evaluation was undertaken concurrently with a randomized trial comparing a Caregiver Support Program (CSP) with existing conventional community nursing care for those caring for elderly relatives at home. The differences in resource consumption were compared with changes in caregiver quality of life, as measured by the Caregiver Quality of Life Instrument (CQLI). A 20% difference from baseline in the CQLI favored the experimental (CSP) group, although this did not reach conventional levels of statistical significance. A comparison of improvement in quality of life with costs implies an incremental cost per quality-adjusted life year gained of Canadian $20,000 for the CSP, which compares favorably with other health care interventions. Further, larger studies are required to confirm this result.

scholarly journals Patiromer (Veltassa)

2021 ◽  
Vol 1 (6) ◽  
Author(s):  
Reimbursement Team
Keyword(s):  
Clinical Evidence ◽  
Budget Impact ◽  
Maximum Dose ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Quality Adjusted Life ◽  
List Prices

Clinical evidence suggests that Veltassa should be reimbursed to treat hyperkalemia in adult patients with chronic kidney disease and who are receiving renin-angiotensin-aldosterone system inhibitor therapy. Economic evidence suggests that at least an 85% price reduction is needed to ensure Veltassa is cost-effective at a $50,000 per quality-adjusted life-year threshold. Higher price reductions may be required if Veltassa is used long term, more patients use the maximum dose, and/or the benefit of renin-angiotensin-aldosterone system inhibitor administration is lower. Based on public list prices, the 3-year budget impact is $86,948,298.

scholarly journals Modern aspects of the study of the quality of life in children with cystic fibrosis

2019 ◽  
Vol 19 (1) ◽  
pp. 43-48
Author(s):  
M. S. Samsonova ◽  
O. I. Simonova ◽  
Irina V. Vinyarskaya
Keyword(s):  
Quality Of Life ◽  
Cystic Fibrosis ◽  
Pharmacoeconomic Analysis ◽  
Quality Adjusted Life Year ◽  
Therapeutic Approaches ◽  
Health Related ◽  
The One ◽  
Practice Methods ◽  
Quality Adjusted Life

There is presented a review of recent data on the changes in quality of life (QL) in children suffering from cystic fibrosis (CF). The recurrence of acute pulmonary infections was shown to significantly reduce health-related QL. In this aggressive treatment of exacerbations ofpulmonary infection leads to a significant improvement in QL, and to gain in the life expectancy ofpatients with CF. Used in clinical practice methods demonstrate the effectiveness in the short term period, but their impact on health-related QL has not yet been studied. The use of the concept of Quality adjusted life year (QALY) in conjunction with the pharmacoeconomic analysis is the one out of promising directions, which allows in the comparative plan to determine the ratio between cost and effectiveness, safety and QL in alternative schemes of treatment of the disease. The use of the QALY index in the analysis of the CF will allow to execute the cumulative determination as the ratio of "cost-effectiveness", and the influence of the conducted therapy on health-related QL ofpatients, which is an inherent component of the evaluation of the estimation of usefulness of specific therapeutic approaches.

Quality of Life and Resource Allocation

1988 ◽  
Vol 23 ◽  
pp. 33-55
Author(s):  
Michael Lockwood
Keyword(s):  
Quality Of Life ◽  
Resource Allocation ◽  
Quality Adjusted Life Year ◽  
Medical Resources ◽  
Medical Vocabulary ◽  
Quality Adjusted Life

A new word has recently entered the British medical vocabulary. What it stands for is neither a disease nor a cure. At least, it is not a cure for a disease in the medical sense. But it could, perhaps, be thought of as an intended cure for a medicosociological disease: namely that of haphazard or otherwise ethically inappropriate allocation of scarce medical resources. What I have in mind is the term ‘QALY’, which is an acronym standing for quality adjusted life year. Just what this means and what it is intended to do I shall explain in due course. Let me first, however, set the scene.

Cost-effectiveness of pedometer-based versus time-based Green Prescriptions: the Healthy Steps Study

2012 ◽  
Vol 18 (3) ◽  
pp. 204 ◽  
Author(s):  
William Leung ◽  
Toni Ashton ◽  
Gregory S. Kolt ◽  
Grant M. Schofield ◽  
Nicholas Garrett ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Community Care ◽  
Cost Effective ◽  
Quality Adjusted Life Year ◽  
Related Quality ◽  
Health Related ◽  
The Cost ◽  
Care Costs ◽  
Quality Adjusted Life

This paper reports on the cost-effectiveness of pedometer-based versus time-based Green Prescriptions in improving physical activity and health-related quality of life (EQ-5D) in a randomised controlled trial of 330 low-active, community-based adults aged 65 years and over. Costs, measured in $NZ (NZ$1 = A$0.83, December 2008), comprised public and private health care costs plus exercise-related personal expenditure. Based on intention-to-treat data at 12-month follow up, the pedometer group showed a greater increase in weekly leisure walking (50.6 versus 28.1 min for the time-based group, adjusted means, P = 0.03). There were no significant between-group differences in costs. The incremental cost-effectiveness ratios, for the pedometer-based versus time-based Green Prescription, per 30 min of weekly leisure walking and per quality-adjusted life year were, (i) when including only community care costs, $115 and $3105, (ii) when including only exercise and community care costs, $130 and $3500, and (iii) for all costs, −$185 and −$4999, respectively. The cost-effectiveness acceptability curves showed that the pedometer-based compared with the time-based Green Prescription was statistically cost-effective, for the above cost categories, at the following quality-adjusted life year thresholds: (i) $30 000; (ii) $30 500; and (iii) $16 500. The additional program cost of converting one sedentary adult to an active state over a 12-month period was $667. The outcomes suggest the pedometer-based Green Prescription may be cost-effective in increasing physical activity and health-related quality of life over 12 months in previously low-active older adults.

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